Physician, Heal Thyself

Summary:

For a trainee surgeon, death is a part of life - sometimes in surgery you do everything right and the patient still dies. But when Agron's brother dies suddenly after intervening in a bar fight, it knocks him sideways, and as he's trying to get his life back on track, he also has to deal with his guilt-stricken estranged father trying to re establish contact, and going about it with all the bull-headed tenacity and lack of social graces that he passed on to Agron. A new relationship with one of the new doctors is the absolute last thing he needs, but unfortunately Nasir seems to be exactly Agron's type

Skip to the end if you need more details on the Major Character Death/ Graphic Violence/ Blood/ Lots of blood tags

Notes:

I've been sitting on this thing for literally years, so even though I don't normally start posting until the whole thing's finished, I'm just going to put this out there anyway, and if I never finish I'll just put up what I've got. I decided there needed to be a fic where the gladiators are surgeons, since they're the only people in modern society who get to open up people's body cavities and not go to prison. Also I know a few people who work in healthcare, and I think it's really interesting. I also think after having a friend sob on my shoulder through her first year of practicing medicine, I have some idea of what it might be like to be a doctor.

Caveat: I have a lot of friends and family members who work in healthcare, and I talk to them about their work, and I've supplemented what they've told me with internet research and watching documentaries, but I don't have that much direct experience of the health service, and I'm not medical myself so apologies for any inaccuracies.

This fic is set in Scotland, to make it easier for myself. It's going to be loooong, and Nasir's going to take a while to show up, but he'll arrive, don't worry!

Notes:

Chapter Text

Duro got up. “I’ll get the next one in.” he said. “What do you want?”

“Does this mean you’re actually going to get people what they want, and not just get Tennant’s for everyone?”

“Nope. Don’t know why I bothered, really. Tennant’s for all!” He raised his fists above his head in a victorious pose, and Agron wondered if he was drunk enough that Agron needed to take him home. If it was anyone else, it probably would mean that, but it was Duro, so…

He turned back to Duro’s friend, Diona.

“Where did you say you were from again?” he asked.

They were slightly distracted by a bit of pushing and shoving up at the bar, as a couple of guys got into a heated argument, shouting loud enough to drown out the music, but not clearly enough for Agron to have the faintest idea what they were talking about. They ignored it, until the sound of breaking glass made them all whip their heads round.

“Aw, shit, has someone got a broken bottle now?” Diona said. She sounded resigned, the way that only people who have spent a lot of time in dodgy pubs can sound resigned to broken bottles flying around. But then one of the others – Kai, Agron think Duro said his name was – stood up slightly, craning his neck to see over the crowd.

“Duro.” he said softly, and Agron saw him. The other guy, Kai, would later tell him that he saw Duro try to get between the guy with the bottle and the guy whose face he was aiming it at, and saw the wild swing of the guy’s arm send the broken end of the bottle deep into the side of Duro’s neck. All Agron saw was Duro swaying, his hand drifting upwards, to the gigantic, jagged wound that had just appeared there. How could his shoulder already be soaked with blood? He collapsed onto his knees, and then onto his side, his head hitting a bar stool on the way down, but by that time Agron was already out of his seat.

“Duro?” he said calmly, authoritatively, as he strode over to the gap that had suddenly opened up as people backed away. Other people would tell Agron later that the guy with the bottle had dropped it and run away when Duro went down, but Agron acquired tunnel vision, and didn’t notice. He knelt down next to Duro and clamped a hand to the side of his neck, blood immediately coating his hand and wrist. Normally when he touched someone who was bleeding, he was wearing sterile gloves. It was so much worse with your bare hand – warmer and stickier and realer. He grabbed Duro’s shoulder, above his collarbone, and squeezed with his other hand.

“Can I get a towel or something please?” he shouted, trying to turn Duro over without removing his gore-soaked hand from his neck. People arrived – Kai and Diona – and helped to turn him onto his back. Something dangled over the side of the bar, and he grabbed at it. It was a tea towel. He pressed it to the wound and grabbed the first hand he could get, which turned out to be Diona’s.

“Hold that.” he said. “Duro! Duro, man, if you can hear me, squeeze my fingers.” Nothing. Not even a twitch. And, on looking at his neck, he saw that blood was seeping out of the wound around the towel.

“Not like that!” he snapped at Diona. “Hold it like you mean it.” With a small squeak, she pressed more firmly, and the towel almost soaked through. She went to remove it.

“No! Don’t take it off, put another one on top. Can I get another towel please?”

“Is he going to be OK?” she whispered, and Agron did not answer because, somewhere in the back of his mind, he knew, and he did not want to. Kai passed Diona another towel and, with shaking hands, she pressed it down over the first one.

“I’m calling an ambulance.” Kai said, and leaned over the bar to ask the girl for the pub’s exact address. Agron pressed down, really fucking hard, on Duro’s eyebrow.

“Duro! Duro, open your eyes. Duro, I swear to fucking God, if you do not open your fucking eyes!”
He did not open his fucking eyes. Agron, working on autopilot, tilted Duro’s head back, opened his mouth and looked inside for an airway obstruction, before feeling his neck, on the opposite side to the wound, for a pulse. He put his cheek close to Duro’s mouth, feeling for breath on his face as he watched his chest for movement. Nothing. No pulse.

“Has he got a pulse?” Kai asked.

“Give me a minute.” Agron muttered, even though he knew that the guidelines were to not feel for a pulse for more than ten seconds, and that he, after so many years of experience, could locate one in less than a second. Come on, he thought. Give me something, just give me one little flicker. Nope.

With a shaking voice, Diona asked for another towel, and someone handed her one. Agron reached down and shoved Duro’s shirt up, feeling with the tips of his fingers in the spot where he knew his heart was, having practiced cardiac examination on him many times while he was at medical school.

“What are you doing?” Diona asked.

“Feeling for his heart.” Agron said. Nothing.

“Hi. I’m the first aider.” A new voice said. Agron looked up. Pretty girl, probably twenty, hair in a ponytail. She looked terrified.

“Surgeon.” Agron said absently. “I’ve resuscitated more people than you’ve had hot dinners.”

“Oh.” the girl said.

“Make sure she doesn’t run out of towels.” Agron said, trying to indicate Diona with his head, without lifting it from hovering over Duro’s face. “Right, he’s in cardiac arrest, I’m going to start chest compressions.”

Kai relayed this into the phone, as Agron positioned himself on his knees, hovering over his brother’s chest. He took a split second to steel himself before pressing the heel of his hand into Duro’s breastbone and pushing down, hard.

Agron was a big, strong guy, and his technique for chest compressions was fairly efficient, since he’d had a fair bit of practice. But every patient – every ribcage – was different, and it normally took a couple of compressions to get the depth right. Normally it was too shallow at first, but an ominous crack! told Agron he’d been overenthusiastic.

“Was that his ribs?” Diona asked, in a small voice.

“He won’t die of broken ribs.” the first aider girl said. She was crouching next to Agron, watching what he was doing. She probably had a couple of hours of CPR training under her belt, and Agron, who usually had absolute confidence in his chest compressing skills, wished suddenly that he had someone more qualified to tell him if the depth was right or not.

“How big was the wound?” Kai asked.

“It was…” Agron shook his head, as if trying to clear it. “Probably about ten centimetres long, a couple of centimetres wide. Left side of the neck, right… right about where the big blood vessels are.” He realised that he had stopped compressing, and started again.

“You OK? Not getting too tired?”

“Nope. I’ll let you know when I am. You know how to do compressions properly, right?”

“Think so.”

“Good.”

He did eventually let the girl take over compressions, and asked Diona to do a couple of rescue breaths. It wasn’t in the official guidelines for the public any more – mostly because it made people come over all squeamish and not do CPR – but Duro was going a funny colour and Agron didn’t like it. He’d never actually given anyone mouth to mouth – he was usually careful to only be around when someone went into cardiac arrest if there was an oxygen supply and mask around that he could use instead – and didn’t want to start with his brother.

The ambulance crew arrived, stuck Duro on a stretcher, and allowed Agron to ride with them to the hospital mostly because he climbed into the ambulance without asking, and persuading him to get out would take time that Duro didn’t have. At the hospital, he was barred from entering the resuscitation room, and a nurse put him in a free consultation room. The doctors and nurses standing around in the middle of the department, talking, all stared at him as he was led past. Suddenly exhausted, he sat down on one of the chairs and stared at the floor, refusing to let himself think about Duro, and the kind of state he would be in.

There had been a long line of deaths in the resus room, which always made Crixus irritable. The usual ones were bad enough – the ones who shouldn’t even have been there. Two 95 year old ladies had come in on the same day, both with catastrophic intracranial events, one with an actual anticipatory care plan already fucking in place, who wanted to die in her home, not in the hospital. But the previous day a nine year old had died after being hit by a car. He was dead when he came in, basically, but the paramedics had started CPR and his parents had been with him, but even if they hadn’t it wouldn’t have changed a thing – they continued with CPR longer than they would have for an adult, gave him more adrenaline than would be needed to kill him, if he hadn’t been dead already, but their power to resurrect the dead remained stubbornly absent.

Crixus didn’t have children of his own, but he and Naevia wanted to get married and have kids once she had finished medical school and her first two years of training. The medical student who had been in the resuscitation – not doing anything important, fetching and carrying – had cried after the kid died, and had to be sent home early. Crixus hadn’t cried – he had never cried over a patient – but he stalked the department with a grim look on his face, and the mad people who turned up to A&E with stubbed toes and minor stomach upsets went all quiet and agreed that the best thing for them to do was to go home and see their own GP the next day.

So when the ambulance call came in – young man, 27, stabbed in a bar fight, his heart lifted: Finally, someone we can save. He volunteered to join the team the consultant was putting together to resuscitate the patient. He was quite looking forward to it.

But when he saw the guy, his heart sank. This guy was, to use the technical term “gubbed”. No chance. He couldn’t actually see the wound on the side of his neck under all the blood soaked material which had been used to stem the bleeding, but it looked to be right where the big blood vessels were. He had no respiratory effort, no pulse, didn’t have at the scene when the ambulance arrived... One of the paramedics whipped out his phone – he had taken a picture of the gigantic pool of blood at the scene, and even though Crixus only caught a glimpse of it – it was being shown to Barca, the more senior doctor – he could see enough to suspect that he could have exsanguinated. They mentioned his name, Duro, and the fact that his brother had done a good job of initiating Basic Life Support at the scene, and the name sounded familiar, something clicked in the back of Crixus’ brain, but he was a bit preoccupied.

After several rounds of chest compressions and three injections of adrenaline, Barca asked if everyone was happy if they stop. They all chorused “Yes.” and started to tidy up. One of them straightened the patient’s arms so they lay by his sides on the trolley, and Crixus looked at his face properly, now that the oxygen mask had been taken off. He looked so familiar, and Crixus walked round the trolley slightly so that he could see his face the right way up. Whoever said dead bodies looked like they were sleeping had never seen one. The guy’s mouth was open, his eyes half closed, his head at an angle that living people’s heads don’t rest at, because while you’re alive, the muscles of your neck automatically keep your head in a position where your airway will be open. Crixus frowned.

“What’s his name again?” he asked.

“It’s… Duro. Duro Bauer.” Barca said, and then he kept talking but Crixus didn’t hear because there was a rushing in his ears. He remembered sixteen year old Duro throwing up in the toilet of his student flat, Agron sitting behind him and occasionally patting his shoulder, laughing at his plight.

“I know him.” he muttered, and one of the nurses looked up sharply.

“You know him?”

“Yeah, I didn’t recognise him until just now. I lived with his brother when we were at medical school – he works upstairs, he’s cardiothoracic. Fuck. Wee Duro.”

There was a deathly silence. No one was even moving. Barca was studying him, frowning slightly. One of the paramedics finally spoke.

“His brother… Is that the one who’s waiting outside?”

“He’s only got the one brother, so far as I know. Agron.” Crixus tore his eyes away from Duro’s lifeless face. “Where is he?”

“I think one of the nurses was going to stick him in a consultation room. He was covered in blood, his clothes were saturated, you couldn’t put him out in the waiting room.”

“Right.” Crixus looked at Barca. “Can I go and tell him?”

Barca looked long suffering. “David…”

“No. Really. I think he’d like to hear it from me.”

“I don’t know if that’s the best idea.”

“Please.”

Barca sighed. “You can come with me, but as his friend, not as his brother’s doctor. OK? I’ll do the talking. You’re there for moral support for him.”

“Got it.” Crixus said. He didn’t mention that neither himself nor Agron would describe them as friends.

When they asked a passing student nurse, she pointed to the room the bloody guy was in, and when they walked in, Crixus realised that a part of him had been clinging to a desperate hope that it wouldn’t actually be Agron, that it would turn out to be the brother of another Duro Bauer. But when the guy – who had been sitting, leaning his elbows on his knees and looking at the floor – looked up, it was Agron, and Crixus’s heart sank. He started to wonder if this was a good idea, if Barca had been right all along. After staring, apparently unseeingly, at the two of them for a moment, Agron frowned.

“Crixus!” he exclaimed in disbelief.

Crixus’ lip twitched, but he didn’t smile. It wouldn’t have been appropriate.

“Hi Agron.” he said. He indicated Barca. “This is Dr Saidani, one of Duro’s doctors.”

“Right.” Agron nodded. Barca leaned out of the room to grab an extra chair, and Crixus sat in the one next to Agron. He had seen the blood covering his hands and arms, up to the elbow, but on sitting down he finally saw the blood staining Agron’s middle, which had been hidden by his hunched position when Crixus was standing up. He was stained brown from the bottom of his chest down to halfway down his thighs – it had to be a good half a litre or more just on Agron’s clothes. The nurse who put him in here had been right – you couldn’t put him in the waiting room, he’d terrify the other patients.

Barca had got his chair and sat down. He leaned forward slightly, his posture imitating Agron’s. Agron sat up a little straighter, and Barca followed his lead.

“Right…” Agron looked down at his hands, which were covered in blood, as were his arms up to the elbow. “I didn’t think you would, I… I work upstairs, in surgery. I… I know all about the limits of modern medicine.”

“OK. What do you know about your brother’s condition when he came in here?”

“He’d bled quite a lot. I think the bottle maybe got one of his big vessels, he was just hosing out blood. I put pressure on the wound and started CPR – his friends helped, they were really good, but none of them could do chest compressions or rescue breaths so I had a lot to do myself. And, um… nothing happened. No response, no breathing, no nothing.”

“Right. And it must have taken a while for the ambulance to arrive, you must have been exhausted.”

“Well, you’d have to ask them, I don’t know. It felt like forever, I actually was exhausted.”

“I’m sorry to hear that, that must have been really hard.”

“Yeah. But… Duro?”

“Yes, Duro. I’m afraid he didn’t survive.”

Agron’s face, which had been set in a determined, blank sort of expression, slipped into one of abject agony, but only for a moment. Crixus felt a mad urge to reach out and touch his shoulder, but resisted, remembering when he was a junior doctor at the end of a long shift, trying not to cry from stress and exhaustion and having just been shouted at, and hoping that no one would be nice or sympathetic to him because that would set him off.

Agron took a deep, shuddering breath and his face resumed its set, determined expression.

“I was… I think I was expecting that.”

“I am very, very sorry. We did everything we could.”

“No, absolutely, I’m sure you did.” Agron cleared his throat. “Could I… I mean, would I be able to… see…?”

“Yes, I think you can. We’ll bring him in here, if that’s all right. It’ll just be a bit quieter if someone else comes in to one of the other resuscitation bays.”

“Yeah, yeah, absolutely.”

“Tell you what.” Crixus spoke for the first time. “We can get you some scrubs to go home in – you can’t walk around like that.”

Agron looked down at himself, his eyebrows shot up, and Crixus cursed himself internally for not being more sensitive, less direct.

“Shit. Yeah, I didn’t realise.”

“OK.” Barca said. “Crixus, you take this gentleman to get some scrubs, I’ll go through to resus and get them to move his brother.”

He’s already forgotten both their names, Crixus thought. He didn’t blame him, he’d done it himself. Doctors hear a lot of new names every day.

Barca and Crixus stood up, but Agron hesitated, looking at the sink.

“Could I…?” he asked, gesturing hopelessly with his gore-soaked arms.

“Absolutely, go ahead.” Barca said, and left the room.

When Agron went to wash his hands, Crixus realised the guy was shaking violently. He didn’t think he could do much about that, but watched him out of the corner of his eye as he clumsily soaped up and scrubbed his hands. Even in the state he was in, he noticed, he automatically washed his hands like a surgeon, scrubbing each surface of the hands more than once, keeping his fingertips above the level of his elbows at all times. When he was finally finished, Crixus grabbed several paper towels from the dispenser and handed them to him, rather than watch him struggle. Then they walked together to the doctor’s room, Crixus gave him scrubs to change into, and got him a plastic bag for his bloody clothes while he was changing in the bathroom.

When Agron came out, holding his civvies, Crixus held out the bag, and then insisted on carrying it to the room where Duro now lay, as if helping to carry his stuff would in any way impact on his grief. He poked his head round the door, to make sure the staff had made appropriate use of their window to move the body, and found that they had. He let Agron in, and left the bag of clothing and blood on one of the chairs.

“Well, I’ll leave you. If the porter comes, tell them who you are, they’ll wait.” But Agron already knew this, had probably said it to grieving family members before. He left, and walked slowly over to the main hub, where most of the doctors seemed to be huddled in conversation. They looked up and stopped talking when Crixus arrived.

“How’s he doing?” One of the nurses asked.

Crixus sighed.

“I dunno. He was pretty quiet. I think he’s holding it together pretty wel-”

At that moment, a demented howl of grief rent the air, and everyone looked in the direction it had come from – the room where Agron was. Before anyone could tell him not to, Crixus strode towards the room and pulled the door open.

Agron was crouched next to his brother’s bed, one hand on the guardrail, one over his mouth, which was open in a silent scream. He looked up when Crixus walked in.
“I’m sorry, I’m really sorry, I’m so sorry, I didn’t mean-”

“Shh, it’s OK.” Crixus crouched down next to him. “Breathe.”

Agron obeyed, taking a deep shuddering breath. On the out breath, he swore: “Fuck.”

Another deep breath.

“Oh, fuck.”

Another.

“Jesus fucking Christ!” The “Christ” came out as a strangled sob, and Crixus put his arm around Agron’s shoulders. There was one small, stupid part of his brain which wanted him to say “It’s OK.” but he managed to stop it. But he couldn’t think of anything else to say, so he and Agron just crouched there in almost silence, broken only by Agron’s very quiet crying.

The police arrived, and would have interviewed Agron in the room with Duro’s body in it, if Agron had not been worried that they were taking up valuable space in a crowded department. Crixus, quietly thinking that he himself was in no fit state to see any more patients before the end of his shift, let them into the office, which was empty at this time of night, and they talked there. They offered him tissues, but Agron didn’t need them. His eyes were red, but the flash of anguish that had flared up when he saw Duro’s body – his eyes closed, as if in sleep, his skin greyish, his neck neatly bandaged – had faded. He could almost feel it, just out of the corner of his mind. He had the sense of it stalking him, waiting for him to no longer have a distraction, in the form of two policemen trying to catch his brother’s killer. Waiting to pounce, once he was alone and vulnerable.

“We’re going to need your permission to perform a post mortem.”

“A post mortem?” Agron was disbelieving. “Can you not tell what he died of just by looking at him?”

“We’re going to need a forensic pathologist to…”

“Yeah, yeah, yeah. Fine. Do it.”

“I can’t promise when the body will be returned to you. It usually takes a couple of weeks.”

“Really?”

“Um.”

“It’s fine.”

They finished up as quickly as they could, leaving Agron with a card with a number on it to call when he felt ready – but ideally in a couple of days – so he could come into the station and make a full statement about what had happened. He pocketed it, and looked up to see Crixus sticking his head round the door.

“I was just going to send him an email telling him what happened. I’m assuming you won’t be in tomorrow. Or…” Crixus looked at his watch. “Or later today.”

“Um.” Agron was saying “Um.” a lot. “Thanks.”

“Right. I’m done in twenty minutes if you’d like a lift home.”

“OK.”

Agron remained numb until Crixus returned (five minutes later, someone showed up to work early) and led him outside, through the waiting room, to the car park. He dimly remembered being asked if it was OK for Crixus to tell Kai and Diona what had happened, and consenting, and asked where they were.

“Went home already.” Crixus said. “Police spoke to them first, out in the waiting room.”

“Oh.” This struck Agron as odd, but then police did not have the same rules about confidentiality that doctors had, and it was standard practice for them (probably) to take statements from people out in public, where people could listen in. He was glad they had gone, didn’t think he wanted their sympathies. Crixus didn’t offer any, but, once they were sitting in his car, did take Agron’s phone off him and programme in both the police’s number and the number of the morgue, in case he has any questions. Looking at the phone in Crixus’ hand as he typed, frowning, Agron came to a horrifying realisation, and put his face in his hands.

“What?” Crixus asked. “Agron? Agron, what is it? Are you OK?”

“I… fuck. I have to phone my mum.” Crixus looked at him, his face blank. “I have to phone my fucking mother, and tell her that… tell her that her baby’s dead.” His voice cracked on the last word, and he slumped sideways, against the window. Crixus had frozen with his hand over the keypad, and slowly lowered the phone.

“I… I’m really sorry. Want me to stay with you when you call?”

“No! No, I’ll do it when I get home, I… I’ll be fine.” Agron’s lip wobbled, and he was silent. He turned his face away from Crixus, who slowly, cautiously, resumed his task, pointedly ignoring Agron’s ragged breathing, and occasional broken sobs. His task complete, he put the phone in the holder between the two seats, started the car, and began to drive. Neither of them said a word. Agron couldn’t, and Crixus wouldn’t. He knew roughly where Agron lived, but had to ask him for the actual address, which Agron struggled to provide. Crixus wondered if he should be being more sympathetic, but the way Agron was leaning away from him, plastering himself to the far side of the car’s interior, made him think not.

Outside Agron’s building, Crixus stopped the car and turned off the engine. Agron wiped his face violently with the heels of his hands, and glanced sideways at Crixus.

“Thanks.” he said numbly. “For the lift, and… everything.” He meant it, but couldn’t quite manage to sound like he did.

“No! No, I can manage. I… I’ll be…” Agron almost said fine, but it seemed too ridiculous. He began to fumble for the door handle, and after a moment Crixus took pity on him, and leaned over to open it for him.

“Cheers.” Agron said awkwardly, climbing out.

“Agron! Your phone!” Crixus shouted. Agron reached back and took it from Crixus, before beginning to make his way towards the door. For the first time, it occurred to him to check that his keys were in his jeans, not in the jacket he had left in the pub. He found them quickly enough, and fumbled to get the door open. He didn’t realise until he managed it, that Crixus had waited for him to get into the building before driving off.

Agron dragged himself up two flights of stairs and into his flat. He established, after looking through his stuff, that he had left his wallet in the pub. He would have to go and get it, or else cancel his cards, but he would do it later. Now, it was five am, his mother usually got up at six, and he had an hour to figure out how to tell her that her worst nightmare had come true.

Notes:

This chapter contains very graphic bloody violence and explicit descriptions of injury and unsuccessful CPR.